Navigation Links
Survival matching should be used to allocate donated kidneys to transplant recipients
Date:3/17/2011

Ann Arbor, Mich. Providing kidney transplants to patients with the best probability of longer survival would reduce repeat transplant operations and improve life span after kidney transplant, says a U-M researcher in a commentary published in the New England Journal of Medicine March 16.

Alan B. Leichtman, M.D., professor of Internal Medicine at U-M and his co-authors endorsed new concepts designed to improve kidney allocation. These concepts were circulated in February by the Organ Procurement and Transplantation Network (OPTN). The OPTN is the federal contract that oversees solid organ recovery and allocation in the United States.

"We strongly support the concept of rank ordering donated kidneys based upon their potential post-transplant survival, and matching that survival to that of waitlisted kidney transplant candidates," says Leichtman, the commentary's lead author.

"The current deceased donor kidney allocation system allows distribution of kidneys with very short potential survival to candidates with long expected survival. Candidates with long potential lifetimes that received kidneys with short expected survival have twice the repeated transplantation rate than similar recipients who received organs with a longer expected survival rate."

The current U.S. deceased donor kidney allocation system relies primarily upon how long a candidate has been waiting for an organ. However, systems for liver and heart transplantation allocation are based upon candidate medical urgency. The lung allocation system allocates organs based upon a mixture of medical urgency and expected one-year post-transplant survival.

The Organ Procurement and Transplantation Network has released for public comment three proposed concepts for deceased donor kidney allocation.

  1. Using a Kidney Donor Profile Index to rank deceased donor kidneys according to the length of time that the kidney would be expected to function in an average kidney transplant recipient.
  2. Allocating the 20% highest quality kidneys to the 20% of candidates with the longest expected post-transplant survival.
  3. Allocating the remaining 80% of kidneys such that candidates who are within 15 years (older or younger) of the donor's age have highest priority.

Because of the current system and the aging of the candidate pool, post-transplant life span following kidney transplantation in the United States has declined on average by 18 months since 1995, Leichtman says.

The authors say that computer simulations based on the current donor pool suggest that more than 35,000 years of post-transplant survival are lost each year under the current system. Additionally, more than 10,000 years of incremental post-transplant survival -- extra years of life that would not have been achieved without the benefit of transplant also are lost each year.

"We are wasting hundreds of thousands of potential years of life," Leichtman says. "The proposal for survival matching as described in the concept document has the potential to reclaim many of these lost years of life, and therefore warrants serious consideration."

The authors also support using the proposed Kidney Donor Profile Index. The new index provides a more granular and accurate survival estimate for organs.

"We suspect that utilization rates of shorter-lived kidneys will increase with accurate information about their survival potential and reduced opportunity for potentially short-lived candidates to be allocated kidneys with long estimated post-transplant survival," the authors wrote.

About 80,000 people are listed nationwide for a kidney transplant. Demand continues to increase, some of it driven by an unnecessarily high rate of repeat transplantations because kidneys and recipients weren't well matched, says Leichtman.

Kidney transplants are the most common transplants done at the University of Michigan Transplant Center and nationwide. But more than half of those who get wait-listed for a kidney transplant in the U.S. never receive a transplant.

"The lost potential life years, and the increase in the waiting list resulting from an unnecessarily high rate of repeat transplantation are intolerable consequences of the current kidney transplant allocation system," Leichtman says. "There likely are further opportunities for improvements to the proposed system, but the core proposals presented in the concept document, adoption of the KDPI and survival matching, warrant the strongest endorsement and the earliest possible implementation by the kidney transplant community."


'/>"/>

Contact: Mary F. Masson
mfmasson@umich.edu
734-389-5381
University of Michigan Health System
Source:Eurekalert

Related medicine news :

1. The 5 hospital factors that affect heart attack survival
2. Hospital Spending Doesnt Affect Sepsis Survival Rates
3. Study links vitamin D to lung cancer survival
4. BUSM study shows chemoradiotherapy prior to surgery improves survival
5. Herceptin May Boost Long-Term Survival After Aggressive Breast Cancer
6. Nanoparticles increase survival after blood loss
7. Novel methods for improved breast cancer survival
8. Smoking during radiation treatments reduces chance of overall survival
9. Everolimus improves progression-free survival for patients with rare pancreatic cancer
10. Limited lymph node removal for certain breast cancer does not appear to result in poorer survival
11. The death switch in sepsis also promotes survival
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/7/2016)... ... ... AlignLife clinics nationwide are giving back to their communities by collecting toys ... gifts wrapped tightly under a Christmas Tree. AlignLife hopes to spread the joy ... In exchange for generous donations, customers will receive a gift in return. Anyone ...
(Date:12/7/2016)... Honolulu, HI (PRWEB) , ... December 07, 2016 ... ... Dermatology is proud to announce that its fully redesigned website, which launched October ... well as a sleek responsive design and easy-to-navigate layout. Visitors and patients can ...
(Date:12/7/2016)... (PRWEB) , ... December 07, 2016 , ... ... Top 20 Marketing Campaign Winner in the Folio: Marketing Awards competition. Live From ... the year’s best in pioneering, inventive, and ultimately successful projects undertaken by the ...
(Date:12/7/2016)... AZ (PRWEB) , ... December ... ... ElectroMedical Technologies, announced its newest portable bioelectronic medicine device WellnessPro Plus for ... WellnessPro Plus substantially enhances the WellnessPro platform by expanding the treatment modalities ...
(Date:12/7/2016)... ... 2016 , ... “Walking With God: Inspirational Lessons from My Life's Journey”: ... be aware of God's direction in their lives. “Walking With God: Inspirational Lessons from ... active church leader. , Sanford says, “I enjoy sharing the true stories ...
Breaking Medicine News(10 mins):
(Date:12/6/2016)... N.Y. , Dec. 6, 2016  Licenders is bringing their ... This new location in Park Slope at 203 13 th ... Brooklyn clientele. "Our goal is to ... treatment plans are designed to get children right back to class ... are 100% all natural and safe for the whole family," Licenders ...
(Date:12/6/2016)... 2016  "Blood Tests replace Surgical Biopsies. Single ... The Diagnostic, Monitoring and Screening Test opportunities are ... occurring using in vitro blood testing to identify ... backing, has announced a single blood test to ... than the market. New technology that definitively identifies ...
(Date:12/6/2016)... 6, 2016 Diabetes & Obesity Drug Development ... obesity disease cluster is currently dominated by therapeutics indicated ... diabetes mellitus (T2DM), and the majority of the pipeline, ... is attributable to these indications. While products indicated for ... there are a large number of these products in ...
Breaking Medicine Technology: